Care of dying adults in the last days of life: NICE clinical guideline

Paramedics have an increasing role to play in community end-of-life care (EoLC) (Nelson and French, 2012), especially given that the array of symptoms experienced by patients, such as pain, respiratory distress, and confusion, often leads families and carers to call 999 out of fear, lack of control, and inability to cope (Brady, 2013).

Despite the College of Paramedics' Curriculum Guidance (2015) making mention of the need to include palliative and EoLC within paramedic curriculum, specific education remains sporadic—much like out-of-hours specialist EoLC community nursing. This is compounded somewhat by a lack of guidance from the UK Ambulance Services Clinical Practice Guidelines (Association of Ambulance Chief Executives, 2013), which make little specific mention to EoLC.

Ambulance services themselves, however, often have their own policies on the management of palliative and EoLC emergencies, often in line with local referral pathways and commissioning agreements. But given the lack of uniformly national education and guidance on EoLC for paramedics, the publishing of the National Institute for Health and Care Excellence (NICE) guidance: Care of dying adults in the last days of life (NICE, 2015a), is a welcome one.